Mycoses, Volume 0, Issue ja, -Not available-.
Παρασκευή 26 Οκτωβρίου 2018
DC‐SIGN and VDR polymorphisms are associated with chronic form of paracoccidioidomycosis with oral manifestations
Art and Belief
SULLIVAN-BISSETTEMA, BRADLEYHELEN, AND NOORDHOFPAUL (EDS) oup. 2017. pp. 272. £50 (hbk)
Successful surgical excision of cerebral abscess caused by Fonsecaea monophora in an immunocompetent patient and review of literature
Abstract
Cerebral abscesses caused by dark-pigmented Fonsecaea fungi are rare, especially in otherwise healthy individuals. In this case report, we present a 61-year-old man from Moldova, living in the Czech Republic, who had worked as a locksmith on oil platforms in Turkmenistan, Kazakhstan, Sudan, and Iraq since 1999, and was admitted to a neurology ward for a sudden motion disorder of the right leg, dysarthria, and hypomimia. Imaging revealed presence of expansive focus around the left lateral ventricle of the brain and a pronounced peripheral edema. The intracranial infectious focus was excised under intraoperative SonoWand guidance. Tissue samples were histologically positive for dark-pigmented hyphae, suggesting dematiaceous fungi. Therefore, liposomal amphotericin B therapy was initiated immediately. Fonsecaea monophora was provisionally identified using ITS rDNA region sequencing directly from brain tissue. The identification was subsequently confirmed by cultivation and DNA sequencing from culture. The strain exhibited in vitro sensitive to voriconazole (MIC = 0.016 μg/mL) and resistance to amphotericin B (MIC = 4 μg/mL); therefore, the amphotericin B was replaced with voriconazole. Postoperatively, a significant clinical improvement was observed and no additional surgery was required. Based on the literature review, this is the third documented case of cerebral infection due to this pathogen in patients without underlying conditions and the first such case in Europe.
Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD) in adults: Design and pilot study in nursing home residents
Publication date: Available online 25 October 2018
Source: Journal of Tissue Viability
Author(s): Karen Van den Bussche, Sofie Verhaeghe, Ann Van Hecke, Dimitri Beeckman
Abstract
Study aim
The aim of this study was to develop a Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD), to psychometrically evaluate and pilot test the instrument in nursing homes. Comparable to the MDS for pressure ulcers, the MDS-IAD aims to collect epidemiological data and evaluate the quality of care.
Materials and methods
After designing and content/face validation by experts and clinicians, staff nurses assessed 108 residents (75.9% female, 77.8% double incontinent) in a convenience sample of five wards. A second nurse independently assessed fifteen residents to calculate inter-rater agreement (p0) and reliability [Cohen's Kappa (ĸ)].
Results
The ĸ-value for 'urinary incontinence' was 0.68 [95% confidence interval (CI) 0.37–0.99] and 0.55 (95% CI 0.27–0.82) for 'faecal incontinence'. The p0 for severity categorisation according to the Ghent Global IAD Categorisation Tool (GLOBIAD) was 0.60. IAD was diagnosed in 21.3% of the residents. IAD management mainly involved the application of a leave-on product (66.7%), no-rinse foams (49.1%), toilet paper (47.9%), and water and soap (38.8%). Fully adequate prevention or treatment was provided to respectively 3.6% and 8.7% of the residents.
Conclusion
This instrument provides valuable insights in IAD prevalence at organisational level, will allow benchmarking between organisations, and will support policy makers. Future testing in other healthcare settings is recommended.
Thromboxane-induced α-CGRP release from peripheral neurons is an essential positive feedback loop in capsaicin-induced neurogenic inflammation
α-Calcitonin gene-related protein (α-CGRP) is synthesized by sensory nerves in the dermis and its release can cause vasodilatation and local inflammation. Its vasorelaxant effects are based on the direct activation of smooth muscle and endothelial cells as well as the activation of mast cells causing the release of vasoactive and proinflammatory mediators. Here, we show that in the capsaicin model for neurogenic inflammation capsaicin-induced edema formation is mediated by α-CGRP and mast cells but is absent in thromboxane receptor (TP)-deficient mice.
Dermatitis herpetiformis and celiac disease increase the risk of bullous pemphigoid
Bullous pemphigoid (BP) and dermatitis herpetiformis (DH) are autoimmune bullous skin diseases. DH has been described to evolve into BP and the two diseases can have overlapping clinical appearances and diagnostic findings, but the association between DH and BP has not previously been studied in a large population. To evaluate DH and celiac disease (CD) as risk factors for BP we conducted a retrospective case-control study of patients with BP and matched controls with basal cell carcinoma diagnosed in Finland between 1997 and 2013.
Syringaresinol reverses age-related skin atrophy by suppressing FoxO3a-mediated MMP2 activation in SOD1-deficient mice
Aging is characterized by accumulation of chronic and irreversible oxidative damage, chronic inflammation, and organ dysfunction. Superoxide dismutase (SOD) serves as a major enzyme for cellular superoxide radical metabolism and physiologically regulates cellular redox balance throughout the body. The copper/zinc superoxide dismutase (SOD1)-deficient mice showed diverse phenotypes associated with enhanced oxidative damage in whole organs. Here, we found that oral treatment with syringaresinol (SYR, also known as lirioresinol B), which is the active component in the berries of Korean ginseng (Panax ginseng C.A.Meyer), attenuated the age-related changes in Sod1-/- skin.
Markers of systemic involvement and death in hospitalized cancer patients with severe cutaneous adverse reactions
Cancer patients have increased risk of severe cutaneous adverse reactions, without reliable biomarkers to identify predisposition for associated morbidity and mortality. In hospitalized cancer patients with morbilliform rash, elafin, IL-6, TNF-α were associated with mortality. IL-6, IL-10 were associated with drug-related systemic involvement. These biomarkers may guide future therapeutic research.
A Phase 2, Randomized Dose-Finding Study of Tapinarof (GSK2894512 Cream) for the Treatment of Plaque Psoriasis
Novel topical treatments for psoriasis have not been developed for many years. Tapinarof, a therapeutic AhR modulating agent, is a potential new treatment option for psoriasis patients. Tapinarof, delivered in a 1% cream, achieved ≥75% improvement in Psoriasis Area and Severity Index in 60% of patients treated once daily.
Catfish mucus alters the Flavobacterium columnare transcriptome
Abstract
Columnaris disease, caused by Flavobacterium columnare, severely impacts the production of freshwater finfish species. Therefore, efforts to better understand the biological processes of F. columnare, including the formation of biofilms and their contribution to disease, are ongoing. In this study, we incubated F. columnare cultures with channel catfish mucus and used high-throughput RNA sequencing to evaluate global changes in gene expression. Our data show that mucus activates in vitro biofilm formation. The analysis of F. columnare transcriptomes after the addition of mucus revealed significant differentially expressed genes (DEGs) between the planktonic and biofilm states. DEGs common among all biofilms were enriched for gene ontology groups including signal transduction, ligand binding and cellular homeostasis and are likely necessary for biofilm formation. Iron acquisition systems included TonB-dependent receptor and ferroxidase genes were expressed among all biofilms, while siderophore synthesis genes were only expressed in mucus-stimulated biofilms. The current analysis of F. columnare transcriptomes adds valuable information about the basic biological processes that occur during the planktonic and biofilm states. This work serves as a basis for future studies on understanding how biofilms are established and how they contribute to disease progression.Should Self-Driving Cars Have Ethics?
To design a "moral machine," researchers updated a classic thought experiment for the autonomous vehicle age. But do we really want artificial intelligence making decisions on who lives or dies?
(Image credit: Andreas Arnold/Bloomberg via Getty Images)
Hochwasserprognose in der Steiermark – Erfahrungen und Herausforderungen
Zusammenfassung
Der Hydrographische Dienst Steiermark betreibt grenzüberschreitende Hochwasserprognosemodelle für die großen Flüsse in der Steiermark (Mur mit Slowenien und Ungarn, Raab mit Ungarn) sowie deren wichtigsten Zubringer. Im folgenden Beitrag werden die Erfahrungen im Modellbetrieb im internationalen Kontext sowie die damit in Verbindung stehenden Herausforderungen beleuchtet.
Kontinuität und Wandel: Die Hydrographie Österreichs – 125 Jahre Wasser-Wissen schaffen
Zusammenfassung
Die vergangenen 125 Jahre brachten vielfältige Veränderungen in gesellschaftlicher und technischer Hinsicht. Der Bogen spannt sich von der Monarchie bis zur Europäischen Union, vom Schreibstreifen zum Datensammler, von der telegrafischen Wasserstandsübertragung zur Übertragung via Satellit. Trotz aller Widrigkeiten blieb die 1894 festgelegte Organisationsform der Hydrographie Österreichs in ihrer grundsätzlichen Ausrichtung bestehen. Der Klimawandel und die rasante Entwicklung der elektronischen Datenverarbeitung fordern von der Hydrographie neue Lösungen, vor allem zur Zusammenstellung und Exploration großer Datensätze. Historische Daten müssen in ein Datenbanksystem integriert werden, das nachhaltig für das Management langer Zeitreihen ausgelegt ist. Zwar wird das Hydrographische Jahrbuch noch immer publiziert, aber es ist nicht mehr die einzige Form, in der geprüfte Daten und Auswertungen zur Planung wasserwirtschaftlicher Maßnahmen für die Öffentlichkeit und die Wissenschaft zur Verfügung gestellt werden.
Scientists And Parents Band Together To Research Cures For Rare Childhood Cancer
A research start-up is connecting parents with scientists in hopes of sparking new research on diseases whose survival rates and treatment options haven't budged in 30 years
(Image credit: Alex Walsh for NPR)
Grain size analysis of California waterbodies to determine the spatial extent and temporal trends of depositional areas where hydrophobic organic compounds could accumulate
Abstract
The objective of this study was to summarize the grain size data from 1993 to 2016 from California water bodies and determine the number and percent of sites where sediment samples are primarily depositional sediment (more than 50% silt/clay) or non-depositional sediment (less than 50% silt/clay). Fine grain depositional areas were of interest because these are areas where hydrophobic organic compounds (HOCs) can accumulate if sources exist. Trends analysis of percent silt/clay data were conducted for all nine California Water Board Regions if adequate data for this type of analysis were available. Sediment sampling protocols were reviewed for all the grain size measurements to determine if depositional areas were targeted or random sampling was conducted. Twelve of the 13 sediment sampling protocols targeted depositional areas. Based on 23 years of data from 685 sites (1859 observations) in all 9 California Regions, the summary analysis showed that only 58% of the sites were considered depositional areas even when targeted sampling for depositional areas was used. Since only slightly more than half the sites were reported as depositional areas based on sampling that targets depositional areas, these results would certainly suggest that depositional areas are not dominant. In fact, for the one protocol where random sampling was used, depositional areas were not reported to be dominant. From an ecological risk perspective, the implication of this finding is that HOCs would not be expected to accumulate in the dominant type of sediment found in most California waterbodies. Trends analysis of percent silt/clay data showed mixed results for the various California Regions.
Enhancement of visible-light photocatalytic activities of BiVO 4 coupled with g-C 3 N 4 prepared using different precursors
Abstract
Graphitic-like carbon nitride (g-C3N4) photocatalyst was synthesized by a facile chemical pyrolysis method, which was built on the self-condensation of different precursors to generate g-C3N4, e.g., melamine, urea, and thiocarbamide. And the different precursors produced a great influence on the photocatalytic activities of g-C3N4. Heterojunctions of g-C3N4 and BiVO4 were synthesized using a facile solvent evaporation method. The formation of BiVO4/g-C3N4 composites were confirmed by XRD, FT-IR, SEM, XPS, and UV-Vis DRS. The photocatalytic activities for RhB degradation were evaluated under visible-light irradiation. The photocatalytic activity of g-C3N4 prepared by urea was higher than that of g-C3N4 prepared by melamine and thiocarbamide, which was attributed to its favorable dispersibility, larger specific surface area, and higher oxidation capacity. The heterojunction composites exhibited higher photocatalytic activity than pure g-C3N4 or BiVO4. The results showed obvious removal efficiency for RhB, and the optimal sample with a BiVO4 content of 10% exhibited higher efficiency than pure g-C3N4 and BiVO4, and 10 wt%BiVO4/CN-U showed the highest photocatalytic activity. The enhanced photocatalytic activity of BiVO4/g-C3N4 composite can be attributed to the intimate coupling between the two host substrates, resulting in an efficient charge separation.
Atmospheric monitoring of organochlorine pesticides across some West African countries
Abstract
Most African countries have ratified the Stockholm Convention on persistent organic pollutants (POPs) and are expected to reduce emissions of POPs such as organochlorine pesticides (OCPs) to the atmosphere. Emerging evidence, however, suggests that there are contemporary sources of OCPs in African countries despite the global ban on these products. This study investigated the atmospheric contamination from OCPs in four West African countries—Togo, Benin, Nigeria, and Cameroon—to ascertain the emission levels of OCPs and the characteristic signatures of contamination. Polyurethane foam (PUF) disk passive air samplers (PAS) were deployed in each country for ca. 55 days in 2012 and analyzed for 25 OCPs. Hexachlorocyclohexanes (HCHs) and DDTs constituted the highest burden of atmospheric OCPs in the target countries, at average concentrations of 441 pg m−3 (range 23–2718) and 403 pg m−3 (range 91–1880), respectively. Mirex had the lowest concentration, ranged between 0.1 and 3.3 pg m−3. The concentration of OCPs in rainy season was higher than in dry season in Cameroon, and presupposed inputs from agriculture during the rainy season. The concentrations of ∑25 OCPs in each country were in the following order: Cameroon > Nigeria > Benin > Togo. There was significant evidence, based on chemical signatures of the contamination that DDT, aldrin, chlordane, and endosulfan were recently applied at certain sites in the respective countries.
Assessment the activity of magnetic KOH/Fe 3 O 4 @Al 2 O 3 core–shell nanocatalyst in transesterification reaction: effect of Fe/Al ratio on structural and performance
Abstract
Recently, biodiesel production using heterogeneous catalysts has been of great concern. However, simple separation of these catalysts from product mixtures is a problem of the process. In this study, series of magnetic KOH/Fe3O4@Al2O3 core–shell nanocatalysts were synthesized via the incipient wetness impregnation method and the effect of weight ratio of Fe3O4-to-Al2O3 (0.15–0.35) on the catalytic performance was assessed. The samples were characterized by XRD, FTIR, BET-BJH, VSM, SEM, TEM, and EDX analyses and their basicity was measured by the Hammett indicator method. The results revealed that although the magnetic KOH/Fe3O4@Al2O3 nanocatalyst with 25 wt% of Fe3O4 showed less activity as compared to those with 15 wt% of Fe3O4, it exhibited higher surface area and appropriate magnetic properties. The sample presented superparamagnetic properties with the magnetic strength of 1.25 emu/g that was simply recovered by using an external magnetic field. The nanocatalyst converted 98.8% of canola oil to biodiesel under reflux condition at the best operational conditions of 12 M ratio of methanol/oil, 4 wt% of catalyst and 6 h of reaction time. Moreover, the nanocatalyst showed high reusability such that it was reused several times without appreciable loss of its catalytic activity.
Cleaner emissions from a DI-diesel engine fueled with mahua oil and low carbon ethanol-hydrogen in dual fuel mode
Abstract
This work is all about utilization of more than two low carbon fuels in a diesel engine with a main objective of reducing harmful emissions. Initially, test engine was tested with a non-petroleum-based fuel namely mahua oil, under different load conditions. In the second phase of the work, test engine was modified into dual fuel mode with slight modification in the intake manifold for the admission of a low carbon high octane primary fuel namely ethanol. The engine was tested by varying the ethanol energy share (EES) from 5% to the point at which engine tends to knock at 100% and 40% of the maximum engine power output. Finally, an attempt was made to induct a zero carbon high octane fuel (i.e., hydrogen) in the intake manifold of the dual fuel engine operated with mahua and ethanol and tested for the behavior. Experimental results claimed that inclusion of ethanol improved the brake thermal efficiency (BTE) only at the higher loads. Optimized EES at 100% load conditions was identified as 15%. It is found that injection of ethanol significantly reduced the harmful emissions like smoke and oxides of nitrogen at the price of increased hydrocarbon and carbon monoxide emissions. It is also inferenced that BTE was improved further with the increases of hydrogen flow rate at peak load. Interestingly all the carbon-based emissions were drastically reduced with the inclusion of hydrogen. However, the oxides of nitrogen emission were found to be increased with increase of hydrogen flow rate.
Erosive pustular dermatosis of the scalp: a neutrophilic folliculitis within the spectrum of neutrophilic dermatoses. A clinicopathologic study of thirty cases
Publication date: Available online 25 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Carlo Tomasini, Andrea Michelerio
Abstract
Background
It is general opinion that histopathology is nonspecific and of little value in diagnosing erosive pustular dermatosis of the scalp (EPDS).
Objectives
Clinicopathologic correlation of erosive pustular dermatosis of the scalp.
Methods
The clinical and pathological records of patients with a clinicopathologic diagnosis of EPDS, between 2011-2016, at the Dermatopathology Unit of the Turin University were reviewed.
Results
Thirty elderly patients with EPDS were identified, 22 males and 8 females. Androgenetic alopecia was present in 19/30 patients. Triggering factors included mechanical trauma in 10/30 cases, surgical procedures in 4/30, herpes zoster in 1/30. Three patients were affected by autoimmune disorders. The vertex was the most common location. Disease presentation varied markedly from tiny, erosive, scaly lesions to crusted and hemorrhagic plaques, mimicking pustular pyoderma gangrenosum. The pathologic changes differed according to the lesion type and disease duration. Interestingly, a spongiotic and suppurative infundibulo-folliculitis was observed in 8/30 cases.
Limitations
This was a retrospective study.
Conclusions
We believe that the primary lesion of erosive pustular dermatosis of the scalp is a spongiotic, pustular superficial folliculitis. The clinicopathologic similarities with other neutrophilic dermatoses, such as pustular pyoderma gangrenosum, suggest this condition should be included in this spectrum, where pathergy plays a pathogenetic role.
Effect of Post-Injection Facial Exercise on Time of Onset of Botulinum Toxin for Glabella and Forehead Wrinkles: A Randomized Controlled, Crossover Clinical Trial
Publication date: Available online 25 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Murad Alam, Amelia Geisler, Melanie Warycha, Kapila Paghdal, Wanjarus Roongpisuthipong, Daniel I. Schlessinger, Brian R. Chen, Kelly A. Reynolds, Dennis P. West, Emily Poon
Development and Implementation of an Order Set to Improve Value of Care for Patients with Severe Stasis Dermatitis
Publication date: Available online 25 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Susan Nedorost, Sheree White, Douglas Y. Rowland, Beth Bednarchik, Susan Flocke, Teresa L. Carman, Lauren Karpinski, Yiwen Shi
Acquired Obliteration of the Proximal Lacrimal Drainage System
Purpose: We present a series of patients with acquired obliteration of one or more components of the proximal lacrimal drainage system, including puncta and canaliculi. This finding was noted with and without other obstructions or stenoses of the lacrimal drainage system. Review of these patients in search of possible risk factors for this condition and histopathology of two patients are presented. Methods: Medical records of patients treated at the Massachusetts Eye and Ear Infirmary between 2010 and 2016 with diagnosis codes of lacrimal punctum stenosis, stenosis of unspecified lacrimal punctum, epiphora due to insufficient drainage, and epiphora not otherwise specified were retrospectively reviewed. Patients were excluded if there was a history of congenital punctal agenesis, trauma, or any other identifiable etiology of lacrimal system obstruction. Results: Twelve patients were identified with obliterated puncta. Most patients were female (n = 11, 91.7%) and Caucasian (n = 9, 75%). The mean age was 61 years (median 62, range 22–90 years). Clinical findings ranged from one involved punctum to all four puncta, and associated ipsilateral canalicular obstruction was noted in 4 patients (33.3%). The inferior puncta were the more frequently affected structures (61.5%) compared to the superior puncta (38.5%). Nine patients (75%) reported use of topical ophthalmic medications prior to onset of symptoms. The most frequent class of medication implicated was topical antibiotics; however, patients often used a combination of medications. In 2 cases, pathological specimens of the canaliculi revealed absence of a canalicular lumen. Conclusions: Although various combinations of lacrimal system stenoses and obstructions have been described, acquired punctal obliteration is an under-recognized entity. These cases differ from typical punctal stenosis in that the puncta are completely obliterated, and no indication of a punctal opening is clinically detectable. In this study, 3 patients had previously documented normal lacrimal irrigation. The ipsilateral canaliculi were also found to be obstructed in a third of patients. Two patients had complete absence of a canalicular lumen on histopathology. The predominance of inferior punctum involvement, patient history of symptom onset after ipsilateral medication use, and known prior patent irrigation in several cases support the hypothesis that these cases represent a severe yet insidious idiosyncratic reaction to topical medication. Accepted for publication August 19, 2018. The authors have no financial or conflicts of interest to disclose. Presented at the Fall American Society of Oculoplastic and Reconstructive Surgeons meeting November 10, 2017, New Orleans, LA. Address correspondence and reprint requests to Victoria S. Starks, M.D., Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA. © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Correction of Recalcitrant Cicatricial Lower Lid Retraction and Entropion With Transverse Tarsotomy and Tarsoconjunctival Flap
Purpose: To describe a novel technique to correct cicatricial lower lid entropion and retraction using a transverse lower lid tarsotomy with an interposed tarsoconjunctival flap posterior lamellar spacer. Methods: Technique description and retrospective interventional case series. Results: Four patients underwent the procedure—two with complications following treatment of sinonasal carcinoma and two with complications following orbital fracture repair. All patients had failed prior posterior lamellar spacer grafts, including donor sclera, dermis-fat graft, and hard palate mucosa. Average time to flap takedown was 20 (11–28) days, with an average follow-up interval of 8.4 (6.2–11.5) months. All patients had resolution of lower lid entropion and significant improvement of lower lid retraction with an average of 2.8 mm (2.0–4.3) of elevation. There were no serious complications, and all patients reported significant improvement in ocular surface symptoms. Conclusions: Transverse tarsotomy combined with a tarsoconjunctival flap is effective for the correction of cicatricial lower lid retraction and entropion in eyelids that have failed surgery with traditional posterior lamellar spacer grafts. Accepted for publication September 18, 2018. The authors have no financial or conflicts of interest to disclose. Presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery Spring Scientific Symposium on June 3, 2018 in Austin, TX. This study was approved by The Ohio State University Institutional Review Board. Address correspondence and reprint requests to Raymond I. Cho, M.D., F.A.C.S., Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, OH. E-mail: raymond.cho@osumc.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Fractionated Stereotactic Radiotherapy for Cavernous Venous Malformations of the Orbital Apex
Purpose: The objective of this study was to investigate the efficacy and safety of fractionated stereotactic radiotherapy in the treatment of cavernous venous malformation of the orbital apex. Methods: The authors reviewed a prospective database from a single center of patients with cavernous venous malformation of the orbital apex who had treatment with fractionated stereotactic radiotherapy. The authors compared the symptoms, visual function and the size of the tumor pre- and posttreatment as well as reviewed the treatment details and the incidence of complications. Results: Six patients received treatment with fractionated stereotactic radiotherapy for cavernous venous malformation involving the orbital apex. The median age was 48 (range, 32–63), and 50% were female. Patients received a dose of 45 to 50.4 Gy in 1.8 to 2 Gy fractions. Median follow up was 33 months (range, 18–66 months). The average tumor volume reduction at posttreatment imaging after 12 months was 63%. All lesions reduced in size postradiotherapy and remained controlled for the duration of follow up. All patients who had proptosis or a visual field defect had an improvement in the symptoms posttreatment. There were no complications of the treatment. Conclusion: Fractionated stereotactic radiotherapy appears to be a safe and effective management option for cavernous venous malformation of the orbital apex and leads to a sustained reduction of the volume of the lesion with associated improvement in symptoms and visual function. Accepted for publication August 14, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Gishan Ratnayake, M.B.B.S., Alfred Health Radiation Oncology, Alfred Hospital, 55 Commercial Road, Melbourne, 3004, VIC, Australia. E-mail: g.ratnayake@alfred.org.au © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Anthropometric Analysis on the Ocular Region Morphology of Children and Young Adults in Chinese Han Population
Purpose: The periocular features vary in different age groups and ethnic populations. In this study, the authors sought to determine whether age-related differences exist for certain periocular parameters between children and young adults of Chinese Han population. Methods: OU of 310 children (aged 7–10 years) and 301 young adults (aged 20–30 years) were evaluated by 2-dimensional photogrammetry. All the subjects were of Chinese Han population. The eyelid crease profiles were classified according to their morphology. Periocular measurements, including 11 linear and 3 angular parameters were acquired from standardized photographs, 3 indices were further derived. The presence of epicanthal fold was also recorded. Each of the parameters was compared between the age groups. Results: A statistical difference was found between the 2 age groups for the distribution of eyelid crease types. Statistical significances existed between the age groups for various parameters, these include palpebral fissure height and width, margin reflex distance, intercanthal and outercanthal width, distance from the medial end of the eyebrow to the medial canthus, distance from the lateral end of the brow to the lateral canthus, crease height and eyebrow height, angle of endocanthion and exocanthion, palpebral fissure inclination, palpebrae fissure index, canthal index, and angular index (p
Spinal Ewing Sarcoma Metastatic to Bilateral Orbits
A 39-year-old woman with primary spinal Ewing sarcoma and known lung metastases presented with painless bilateral decreased visual acuity over a 1-month period. Examination revealed bilateral disc edema. MRI of the brain/orbits showed metastatic lesions to the dura and bilateral orbits. Venous sinus thrombosis extending to the jugular vein was also noted. To the authors' knowledge, this is the first case of bilateral orbital metastasis and papilledema secondary to Ewing sarcoma and related hypercoagulability. Accepted for publication August 29, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Renelle Pointdujour-Lim, M.D., Smilow Cancer Hospital at Yale New Haven Hospital, 35 Park Street, New Haven, CT, 06511. E-mail: Renelle.lim@yale.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Impact of Food and Drug Administration Approval of Vismodegib on Prevalence of Orbital Exenteration as a Necessary Surgical Treatment for Locally Advanced Periocular Basal Cell Carcinoma
Purpose: To test the hypothesis that the US Food and Drug Administration approval of vismodegib in early 2012 has reduced the prevalence of orbital exenteration for locally advanced periocular basal cell carcinoma (BCC). Methods: Following institutional review board approval, the authors reviewed clinical and pathological data of patients with locally advanced periocular BCC (T4 per the eyelid carcinoma classification in the 8th edition of the AJCC Cancer Staging Manual) treated by the senior author during 2006–2018. Patients were grouped into those who were treated before February 2012 ("before vismodegib approval") and those who presented later ("after vismodegib approval"). Results: Forty-two patients with locally advanced periocular BCC were treated during the study period, of whom 31 were men. The median age at presentation was 66 years (range, 43–90). Twenty-two patients had T4a and 20 had T4b tumors. Thirteen patients were treated before and 29 were treated after vismodegib approval. The 2 groups did not differ in age distribution (p = 0.164), sex distribution (p = 0.270), prevalence of recurrent tumor at presentation (p = 0.317), or duration of treatment with vismodegib (p = 0.605). Orbital exenteration was significantly more prevalent in patients treated before vismodegib approval than after (46% vs. 10%, p = 0.016), and vismodegib treatment was significantly more prevalent in patients treated after vismodegib approval than before (when vismodegib was given in clinical trials; 69% vs. 23%, p = 0.008). There was a trend toward more patients retaining their eyes at last follow-up in patients treated after vismodegib approval (83% vs. 54%, p = 0.066). Conclusions: The prevalence of orbital exenteration as a necessary surgical procedure in patients with a locally advanced periocular BCC has fallen since the Food and Drug Administration approval of vismodegib. Although vismodegib is not specifically approved for organ-sparing, it has changed the authors' practice and enabled eye preservation in patients with locally advanced periocular BCC, who would otherwise require an orbital exenteration. Accepted for publication August 31, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Bita Esmaeli, M.D., Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, Unit 1488, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. E-mail: besmaeli@mdanderson.org © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Unilateral Eyelid Swelling as a Sign of Antimelanoma Differentiation–Associated Gene 5 (Anti-MDA5)-Antibody–Positive Dermatomyositis
The authors describe a 40-year-old woman who presented with unilateral eyelid swelling, and later on developed heliotrope rash, extensive oral and cutaneous ulcers, and muscle weakness. She was diagnosed with dermatomyositis associated with antimelanoma differentiation–associated gene 5 antibody. Even after combination of immunosupressants including a corticosteroid, tacrolimus, and rituximab, her eyelid swelling and oral ulcers progressively worsened. Administration of loading and then monthly intravenous immunoglobulin resulted in clinical remission, suggesting that intravenous immunoglobulin could be a useful remedy in cases refractory to conventional immunosuppressive agents, especially those with antimelanoma differentiation–associated gene 5 antibody-dermatomyositis. Accepted for publication September 13, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Stacey C. Lam, M.B.B.S., M.R.C.S.Ed., Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, 147K Argyle Street, Kowloon, Hong Kong Special Administrative Region, China. E-mail: staceylam@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Multicentric Mucinous Adenocarcinoma in the Periorbital Region
Primary mucinous adenocarcinoma of the skin is an uncommon malignancy in clinical practice, but multicentric presentation of the malignancy is considered even more rare. In this case report, the authors present a 70-year-old woman with multicentric primary mucinous adenocarcinoma of the skin manifesting with 2 separate lesions located on the right eyelid and cheek. Lesion removal and immunohistochemical staining ruled out mucinous adenocarcinoma of the skin secondary to lung or thyroid carcinoma, however, was inconclusive for breast carcinoma. A negative breast examination and mammography determined the lesions were primary mucinous adenocarcinoma of the skin. Lesion removal resulted in a large defect, which was repaired using a tarsoconjunctival flap and right cheek rotational/advancement flap. Six months postoperatively, the patient's vision returned to baseline with excellent eyelid position and no evidence of local recurrence. Oral consent for the report and photographs was obtained from the patient and filed. Accepted for publication August 28, 2018. None of the contributing authors involved have any financial or personal interest in this article. The authors have no conflicts of interest to disclose. Address correspondence and reprint requests to Marie B. Somogyi, M.D., TOC Eye and Face, 3705 Medical Parkway Suite 120, Austin, TX 78705. E-mail msomogyi@tocaustin.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Differentiating acute food protein-induced enterocolitis syndrome from its mimics: a comparison of clinical features and routine laboratory biomarkers
Publication date: Available online 25 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Eric Lee, Elizabeth H. Barnes, Sam Mehr, Dianne E. Campbell
Abstract
Background
Food protein-induced enterocolitis syndrome (FPIES) is frequently misdiagnosed and subject to diagnostic delay. Profuse vomiting, the cardinal feature of acute FPIES, may occur in more common paediatric disorders such as gastroenteritis and sepsis.
Objectives
We sought to determine differentiating features at acute presentation between FPIES, gastroenteritis and sepsis in young children presenting to an emergency department (ED) with profuse vomiting.
Methods
We conducted a retrospective case-control study of children aged 6 months to 4 years with a diagnosis of acute FPIES who had presented to ED and compared the clinical features, vital signs and routine laboratory studies of this cohort to similarly aged children presenting to ED with vomiting diagnosed with bacterial/viral gastroenteritis or bacterial sepsis.
Results
181 acute FPIES ED presentations were compared to 55 gastroenteritis and 36 bacterial sepsis ED presentations. Children with FPIES were more likely to present with lethargy, floppiness and pallor. Compared to FPIES, children with sepsis were likely to present with fever, tachycardia, tachypnea and diarrhoea, whilst those with gastroenteritis were likely to present with fever, diarrhoea and blood in stools. Normal CRP, leucocytosis, lymphocytosis, thrombocytosis, low MPV and an elevated albumin/globulin ratio were more commonly seen in FPIES than sepsis or gastroenteritis. No other clinical or laboratory markers examined reliably distinguished between the three disease groups.
Conclusions
In the young vomiting child, lethargy, floppiness, pallor without fever and normal CRP should alert clinicians to a possible diagnosis of FPIES. In contrast a highly elevated CRP is not a feature of FPIES, and in such cases an alternative diagnosis must be considered.
Facile synthetic Photoluminescent Graphene Quantum dots encapsulated β-cyclodextrin drug carrier system for the management of macular degeneration: Detailed analytical and biological investigations
Publication date: Available online 26 October 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Cheng Qian, Panshi Yan, Guangming Wan, Shenzhi Liang, Yi Dong, Jiong Wang
Abstract
Drug administration by effective nano-carriers is an emerging and growing technology in the field of bio-medicine and particularly Age –related macular degeneration (AMD). This developed nanomaterials based methods with drug administration maximizes the biocompatibility and systemically increases drug delivery profile for the drugs. Herein, we described the effective drug molecules delivery profiles by the hydrothermally synthesized graphene quantum dots (GQDs) encapsulated with supramolecular β-cyclodextrin (β-CD) as a drug delivery system for AMD. The drug release profiles were analysed and plotted by two different types of drugs ((Bevacizumab (Bev) and Ranibizumab (Ran))) and compounds displayed an initial burst delivery percentage of 55.7 ± 1.6% and 52.2 ± 2.6, respectively, within 15 min. After 1 h, 94.2% (Ran) and 93.1% (Bev) of loaded drug molecules were released from the β-CD encapsulated GQDs in sustained manner. The biocompatibility of the synthesized carriers was investigated quantitatively and qualitatively with the mouse Fibroblast L929 cell line. The biological cell analysis observed by calculated cell count and green fluorescence visualization has been clearly confirmed the samples are non-toxic and highly compatible to the cells with more than 90% cell viability after 5 days cell culture. The observed material properties and biological results demonstrated that the suitability of the developed nano-carriers for the drug delivery system in the AMD.
Graphical Abstract
Multicenter methodology comparison of the FDA and ISO standard for measurement of in vitro UVA protection of sunscreen products
Publication date: Available online 26 October 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): S. Bielfeldt, E. Klette, M. Rohr, B. Herzog, J. Grumelard, C. Hanay, U. Heinrich, P. Hansen, D. Kockott, J. Lademann, C. Mendrok-Edinger, S. Peters, T. Rudolph, T. Schläger, H. Tronnier, S. Wiechers, L. Zastrow, F. Pflücker
Abstract
In vitro standard methods are available and accepted worldwide to assess UVA protection of sunscreen products. Though, harmonisation of methods has made progress in the last decade, still two differing methods - one by FDA the other by ISO - are in use. In a multicentre study including 9 centres in Germany, 4 different commercial sunscreen products were assessed using both methods to discover their similarities and differences. UVA protection factor and Critical Wavelength were detected at various substrate type (sandblasted versus moulded PMMA plates), at different surface roughness of the plates as well as at different product application dose using two different irradiation spectra.
Results: The strongest influence on UVA protection factor results from the surface roughness of the plates. Depending on the roughness (accepted range of 2 to 7 μm in the FDA method) a variability in the UVA protection factor of up to 25% was observed, while the much narrower definition of plate roughness by ISO (4.5 to 5.2 μm) had no relevant influence on the test results. Sandblasted plates in our assessment led to higher UVA protection factors and produced less scattered results compared to moulded plates. These differences were not pronounced. Application dose and spectra of the irradiation source were of negligible influence on UVA protection factor results for the investigated UV-filter combinations. The UVA protection factor which is the endpoint of the ISO method was found to be a parameter with a high potential to differentiate among different test products. The endpoint of the FDA method - the Critical Wavelength - was found to be an unambitious endpoint. Insensitivity to all described modifications of the method was observed. All investigated products performed similar and passed the Critical Wavelength criteria independent of method and parameters.
Alopecia frontal fibrosante y lupus eritematoso discoide: más allá de la coexistencia
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): P. Fernández-Crehuet, R. Ruiz-Villaverde
Tumoración occipital de rápido crecimiento
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): E. Varas-Meis, C. Prada-García, P. Fernández-Canga, M.Á. Rodriguez-Prieto
Erupción papulosa fotodistribuida
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): L. Schneller-Pavelescu, E. Vergara-de Caso, M.M. Blanes
El síndrome dismorfofóbico, entre otros, y la piel
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): C. Martínez-González
Regresión espontánea de tres nevus melanocíticos congénitos medianos
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): R. Alperovich, M.J. Fiandrino, R. Asial, M.C. Boente
Osteonevus de Nanta, un fenómeno cutáneo poco habitual
Publication date: Available online 25 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): A.V. Alvarado, J.J. Dávila-Rodríguez, B. Vélez, M. Montenegro-Zumárraga
Classification of contrast-enhanced spectral mammography (CESM) images
Abstract
Purpose
Contrast-enhanced spectral mammography (CESM) is a recently developed breast imaging technique. CESM relies on dual-energy acquisition following contrast agent injection to improve mammography sensitivity. CESM is comparable to contrast-enhanced MRI in terms of sensitivity, at a fraction of the cost. However, since lesion variability is large, even with the improved visibility provided by CESM, differentiation between benign and malignant enhancement is not accurate and a biopsy is usually performed for final assessment. Breast biopsies can be stressful to the patient and are expensive to healthcare systems. Moreover, as the biopsies results are most of the time benign, a specificity improvement in the radiologist diagnosis is required. This work presents a deep learning-based decision support system, which aims at improving the specificity of breast cancer diagnosis by CESM without affecting sensitivity.
Methods
We compare two analysis approaches, fine-tuning a pretrained network and fully training a convolutional neural network, for classification of CESM breast mass as benign or malignant. Breast Imaging Reporting and Data Systems (BIRADS) is a radiological lexicon, used with breast images, to categorize lesions. We improve each classification network by incorporating BIRADS textual features as an additional input to the network. We evaluate two ways of BIRADS fusion as network input: feature fusion and decision fusion. This leads to multimodal network architectures. At classification, we also exploit information from apparently normal breast tissue in the CESM of the considered patient, leading to a patient-specific classification.
Results
We evaluate performance using fivefold cross-validation, on 129 randomly selected breast lesions annotated by an experienced radiologist. Each annotation includes a contour of the mass in the image, biopsy-proven label of benign or malignant lesion and BIRADS descriptors. At 100% sensitivity, specificity of 66% was achieved using a multimodal network, which combines inputs at feature level and patient-specific classification.
Conclusions
The presented multimodal network may significantly reduce benign biopsies, without compromising sensitivity.
Explaining the modal force of natural laws
Abstract
In this paper, I will defend the thesis that fundamental natural laws are distinguished from accidental empirical generalizations neither by metaphysical necessity (e.g. Ellis 1999, 2001; Bird in Analysis, 65(2), 147–155, 2005, 2007) nor by contingent necessitation (Armstrong 1983). The only sort of modal force that distinguishes natural laws, I will argue, arises from the peculiar physical property of mutual independence of elementary interactions exemplifying the laws. Mutual independence of elementary interactions means that their existence and their nature do not depend in any way on which other interactions presently occur. It is exactly this general physical property of elementary interactions in the actual world that provides natural laws with their specific modal force and grounds the experience of nature's 'recalcitrance'. Thus, the modal force of natural laws is explained by contingent non-modal properties of nature. In the second part of the paper, I deal with some alleged counterexamples to my approach: constraint laws, compositional laws, symmetry principles and conservation laws. These sorts of laws turn out to be compatible with my approach: constraint laws and compositional laws do not represent the dynamics of interaction-types by themselves, but only as constitutive parts of a complete set of equations, whereas symmetry principles and conservation laws do not represent any specific dynamics, but only impose general constraints on possible interactions.
Autopoiesis, biological autonomy and the process view of life
Abstract
In recent years, an increasing number of theoretical biologists and philosophers of biology have been opposing reductionist research agendas by appealing to the concept of biological autonomy which draws on the older concept of autopoiesis. In my paper, I investigate some of the ontological implications of this approach. The emphasis on autonomy and autopoiesis, together with the associated idea of organisational closure, might evoke the impression that organisms are to be categorised ontologically as substances: ontologically independent, well-individuated, discrete particulars. However, I argue that this is mistaken. Autopoiesis and biological autonomy, properly understood, require a rigorous commitment to a process ontological view of life.
What we (should) talk about when we talk about fruitfulness
Abstract
What are the relevant values to the appraisal of research programs? This question remains hotly debated, as philosophers have recently proposed many lists of values potentially relevant to scientific appraisal. Surprisingly, despite being mentioned in many lists, little attention has been paid to fruitfulness. It is unclear how fruitfulness should be explicated, and whether it has any substantial role in scientific appraisal. In this paper, I argue we should explicate fruitfulness as the capacity to develop of research programs. Moreover, I provide a novel strategy to assess and compare the fruitfulness of programs focused on their research questions and heuristics. To illustrate how this strategy would work, I will discuss a case study, namely the adaptationist program in evolutionary psychology.
ATR/Chk1 pathway is activated by oxidative stress in response to UVA light in human Xeroderma Pigmentosum Variant cells
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Epidemiologic and genetic data suggest the presence of an endemic form of pemphigus foliaceus in Gran Canaria, Spain
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Merkel cells in extraocular sebaceous carcinoma
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Cryptococcus‐like Changes in the Setting of Vasculitis
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Angiolymphoid Hyperplasia with Eosinophilia and Kimura Disease Overlap with Evidence of Diffuse Visceral Involvement
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Erythema Elevatum Diutinum a Rare and Poorly Understood Cutaneous Vasculitis: A Single Institution Experience
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
